Prevalence of cigar use in 22 North American communities: 1989 and 1993

Preference for flavoured cigar brands among youth, young adults and adults in the USA

BACKGROUND

While cigarette consumption in the USA continues to decline, cigar consumption has increased. Tobacco-trade publications suggest that flavoured cigars are driving the recent growth in cigar consumption. Limited survey data exist to explore flavoured cigar preferences among youth and adults.

METHODS

This study used the 2010-2011 National Survey on Drug Use and Health (NSDUH) and Nielsen market scanner data. The NSDUH sample consisted of 6678 past 30-day cigar smokers who reported smoking a usual brand of cigars. NSDUH contains a measure on usual cigar brand smoked and was merged with Nielsen data to estimate the per cent of each cigar brand's market share that is flavoured.

RESULTS

Multivariate analyses indicate that youth, young adults, females, blacks, cigarette smokers, blunt users and daily cigar smokers are significantly more likely to report a usual cigar brand that is flavoured. Preference for a usual brand that produces flavoured cigars decreases significantly with age.

CONCLUSIONS

This study finds recent growth in flavoured cigar consumption and preference among youth and young adults for cigar brands that are flavoured. These findings underscore the need to expand monitoring of product attributes as well as individual-level cigar use behaviours captured through population surveillance.

Cigar use before and after a cigarette excise tax increase in New Jersey

OBJECTIVE

To determine whether cigarette smokers in New Jersey substituted cigars following a cigarette excise tax increase.

METHODS

We examined data from New Jersey's 2001 and 2002 Adult Tobacco Survey (NJATS). Adjusted odds ratios were generated for ever and current cigar use, controlling for demographics and cigarette smoking status.

RESULTS

Males, whites, ever cigarette smokers, and those with higher education reported greater ever and current cigar use in both years. The adjusted odds for cigar use among recent quitters were higher in 2002 than in 2001.

CONCLUSIONS

When other tobacco products' excise taxes fail to keep pace with cigarettes, there is a real potential for product substitution. Cessation of all tobacco products is necessary for the best public health outcome.

Effect of cigar smoking on endothelium-dependent brachial artery dilation in healthy young adults

BACKGROUND

Cigar smoking has become a quickly growing trend among teenagers, women, and young adults. The objective was to explore whether cigar smoking affects flow-mediated vasodilation in healthy, non-smoking young adults.

METHODS

This was a prospective randomized trial with open design. It was performed in a cardiology teaching program in a private community hospital that serves as a major referral center within the greater Miami area. Apparently healthy, non-smoking young adult cardiology trainees and staff between the ages of 20 and 45 years were randomly assigned to a cigar smoking group (n = 15) or a control group (n = 14). The main outcome measures were the difference in percent diameter increase in the brachial artery after reactive hyperemia and sublingual nitroglycerin between members of the cigar smoking and control groups at baseline, measured after cigar smoking, and at 5 hours.

RESULTS

Twenty-nine participants were randomized. Percent diameter increase in the brachial artery was measured with the use of high-resolution ultrasonography. Baseline percent diameter increase after reactive hyperemia and sublingual nitroglycerin was similar in both groups (6.2% vs 6.7%, P = .4 and 22% vs 23%, P = .5, respectively). We observed a 2.5% increase in brachial artery diameter with hyperemia after cigar smoking compared with a 9.4% increase in the control group, P = .045. Values after nitroglycerin were similar between groups, P = .2. Between-group analysis showed no significant difference in percent dilation after reactive hyperemia at 5 hours, P = .4, but a significant difference was seen after sublingual nitroglycerin, P = .02.

CONCLUSIONS

These data are compatible with the possibility that cigar smoking may have an acute effect on endothelium-dependent, flow-mediated brachial artery dilation and do not support the possibility of an immediate effect on endothelium-independent vasodilation. Taken together, these results suggest that cigars are not an innocuous alternative to cigarette smoking.

Cigar, pipe, and cigarette smoking as risk factors for periodontal disease and tooth loss

BACKGROUND

Our purpose was to test the hypotheses that cigar and pipe smoking have significant associations with periodontal disease and cigar, pipe, and cigarette smoking is associated with tooth loss. We also investigated whether a history of smoking habits cessation may affect the risk of periodontal disease and tooth loss.

METHODS

A group of 705 individuals (21 to 92 years-old) who were among volunteer participants in the ongoing Baltimore Longitudinal Study of Aging were examined clinically to assess their periodontal status and tooth loss. A structured interview was used to assess the participants' smoking behaviors with regard to cigarettes, cigar, and pipe smoking status. For a given tobacco product, current smokers were defined as individuals who at the time of examination continued to smoke daily. Former heavy smokers were defined as individuals who have smoked daily for 10 or more years and who had quit smoking. Non-smokers included individuals with a previous history of smoking for less than 10 years or no history of smoking.

RESULTS

Cigarette and cigar/pipe smokers had a higher prevalence of moderate and severe periodontitis and higher prevalence and extent of attachment loss and gingival recession than non-smokers, suggesting poorer periodontal health in smokers. In addition, smokers had less gingival bleeding and higher number of missing teeth than non-smokers. Current cigarette smokers had the highest prevalence of moderate and severe periodontitis (25.7%) compared to former cigarette smokers (20.2%), and non-smokers (13.1%). The estimated prevalence of moderate and severe periodontitis in current or former cigar/pipe smokers was 17.6%. A similar pattern was seen for other periodontal measurements including the percentages of teeth with > or = 5 mm attachment loss and probing depth, > or = 3 mm gingival recession, and dental calculus. Current, former, and non- cigarette smokers had 5.1, 3.9, and 2.8 missing teeth, respectively. Cigar/pipe smokers had on average 4 missing teeth. Multiple regression analysis also showed that current tobacco smokers may have increased risks of having moderate and severe periodontitis than former smokers. However, smoking behaviors explained only small percentages (<5%) of the variances in the multivariate models.

CONCLUSION

The results suggest that cigar and pipe smoking may have similar adverse effects on periodontal health and tooth loss as cigarette smoking. Smoking cessation efforts should be considered as a means of improving periodontal health and reducing tooth loss in heavy smokers of cigarettes, cigars, and pipes with periodontal disease.

Who's smoking now? The epidemiology of tobacco use in the United States and abroad

Numerous epidemiological studies have linked tobacco use with a wide variety of diseases. Strong government-supported anti-smoking campaigns have decreased the prevalence of smoking in many developed countries, including the United States. However, it remains a major public health pariah. In developing countries, such as China, cigarette smoking and other forms of tobacco use continue to increase. If unchecked this will eventually lead to 10 million deaths per year worldwide. Even in the United States, the prevalence of smoking is rising in crucial population groups such as adolescents. Recent advances have made physicians more able to help patients quit smoking, but organized campaigns must be further strengthened to prevent the initiation of tobacco use, especially in the young.

Cigar smoking among college students: prevalence and correlates

BACKGROUND

Cigar smoking is deleterious to health and point prevalence estimates suggest that rates of cigar smoking among young adults may be high. Little is known, however, about the reasons for the popularity of cigar smoking among young adults or the relationship of cigar smoking to cigarette smoking. This study documents the prevalence of cigar smoking in two samples of college students, examines the association between cigar and cigarette smoking, and investigates the hypothesis that cigar smoking is associated with a positive image of the typical cigar smoker.

METHODS

Two cross-sectional surveys of college students were conducted (sample sizes = 745 and 167).

RESULTS

Current cigar smoking was reported by 7 and 19% of the respondents in Studies One and Two, respectively. In both studies, cigar smoking was far more likely among men and among either former or current cigarette smokers. In Study Two, cigar smoking was associated with a positive image of the typical cigar smoker.

CONCLUSIONS

The results suggest that the popularity of cigar smoking among college students is of sufficient magnitude to be a public health concern and may be related to a positive image of the typical cigar smoker.

The epidemiology of tobacco use, dependence, and cessation in the United States

Tobacco use, primarily in the form of cigarette smoking, is the leading preventable cause of death in the United States. After epidemic increases in current smoking in the first half of the 20th century, overall rates of smoking have decreased during the past 30 years. Certain sociodemographic groups continue to have high rates of tobacco use. The prevalence of current smoking in adults in the United States decreased from 42.4% in 1965 to 24.7% in 1995. Recent epidemiologic data indicate that 47 million adults currently smoke cigarettes and over 5 million use smokeless tobacco; over 3 million adolescents are current smokers and over 750,000 use smokeless tobacco. Thus, tobacco use continues to be a major public health concern.